Division of Gastroenterology, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Division of Infection Disease, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Clin Transl Gastroenterol. 2020 Jul;11(7):e00215. doi: 10.14309/ctg.0000000000000215.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic of coronavirus disease 2019 (COVID-19) is a global health crisis. Possible pancreatic involvement has recently been observed in these patients; however, its significance is unclear. The aim of this study was to evaluate the association of significantly elevated lipase with disease outcomes.
Data about demographics, symptoms, laboratory values, and clinical outcomes were collected for 1,003 consecutive patients testing positive for COVID-19. Elevated lipase was defined as greater than 3 times the upper limit of normal (>3 × ULN). Baseline characteristics among patients with or without elevated lipase were compared using Fisher exact test or Student t-test for categorical or numerical variables, respectively. Logistic regression was used to evaluate the association of lipase levels with primary clinical outcomes (intensive care unit admission and intubation) adjusted for age, sex, body mass index, history of diabetes, and hypertension.
Of 1,003 patients with COVID-19, 83 had available lipase levels and were all admitted to the hospital. Of 83, 14 (16.8%) had elevated lipase (>3 × ULN), which was associated with higher rates of leukocytosis (P < 0.001) and abnormal liver enzymes (P < 0.01). Compared with lower lipase levels (<3 × ULN), patients with elevated lipase had higher rates of ICU admission (92.9% vs 32.8%; P < 0.001) and intubation (78.6% vs 23.5%; P 0.002). In a multivariable-adjusted model, higher lipase levels were significantly associated with admission to the ICU and rate of intubation.
Lipase elevation is seen in COVID-19 and is associated with worse disease outcomes.
导致 2019 年冠状病毒病（COVID-19）大流行的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是一场全球卫生危机。最近在这些患者中观察到胰腺可能受累；然而，其意义尚不清楚。本研究旨在评估显著升高的脂肪酶与疾病结局的关系。
对 1003 例连续检测到 COVID-19 阳性的患者收集了人口统计学、症状、实验室值和临床结局的数据。升高的脂肪酶定义为大于正常上限的 3 倍（>3 × ULN）。使用 Fisher 确切检验或学生 t 检验比较有或无升高脂肪酶的患者之间的基线特征，分别用于分类或数值变量。使用逻辑回归评估脂肪酶水平与主要临床结局（入住重症监护病房和插管）的关联，调整年龄、性别、体重指数、糖尿病和高血压病史。
在 1003 例 COVID-19 患者中，83 例有可用的脂肪酶水平，均住院治疗。在 83 例患者中，14 例（16.8%）脂肪酶升高（>3 × ULN），白细胞增多（P < 0.001）和异常肝酶（P < 0.01）的发生率更高。与较低的脂肪酶水平（<3 × ULN）相比，脂肪酶升高的患者入住重症监护病房的比例更高（92.9% vs. 32.8%；P < 0.001）和插管率（78.6% vs. 23.5%；P < 0.002）。在多变量调整模型中，较高的脂肪酶水平与入住重症监护病房和插管率显著相关。
COVID-19 中可见脂肪酶升高，并与更差的疾病结局相关。
